KRASKE: Could Brownback trigger Medicaid expansion in Missouri?

The Kansas City Star

Does Kansas Gov. Sam Brownback hold the keys to whether President Obama’s vast Medicaid expansion plan takes place in … Missouri?

A growing chorus of state officials in both states thinks that’s precisely the case.

In fact, they consider Brownback a pivotal player in several states where lawmakers are still weighing whether to drastically expand their health care programs for the poor to fit Obama’s new health care law.

The new law provides that the federal government will pick up 100 percent of the cost of the expansion. After three years, the feds pay 90 percent.

It’s a multi-billion-dollar inducement to get states to play ball with the new law and covers tens of millions more Americans.

So far, governors in 21 states, including Missouri, have signed on to expanding Medicaid.

“We’re not going to let politics get in the way of doing the best thing for our state,” Democratic Gov. Jay Nixon said.

But his state’s Republicans continue to resist. On Friday, the top GOP budget writer for the Missouri House submitted a budget that strips away Nixon’s proposed expansion.

Several of the 21 states are headed by GOP governors, such as Gov. Rick Snyder of Michigan and John Kasich of Ohio.

Governors in 13 states have said they’re not participating. Five states are leaning against taking part while three others are leaning toward it. Eight states, including Kansas, are in the undecided camp.

And that’s intriguing.

Brownback has been a vocal opponent of the Affordable Care Act, or what’s commonly known as Obamacare. But he’s not ruled out the Medicaid expansion, which surprises his fellow conservatives.

“I would have expected that the governor would have made an announcement by now,” said state Rep. John Rubin, a Shawnee Republican.

If, by chance, Brownback would come out in favor of the program, his prospects of seeing the conservative Legislature go along with him are slim, Rubin said.

Still, imagine the impact a Brownback endorsement would have. It would suck the wind out of Obamacare opponents in Jefferson City and elsewhere around the country.

In one quick move, backing from the conservative Brownback would strip away opponents’ political cover.

“As conservative a state as Kansas is, if they were to expand, it would be an absolute game-changer,” said Missouri state Rep. J.J. Rizzo, a Kansas City Democrat.

Brownback’s concerns center on the magnitude of the expansion and the feds’ ability — or inability — to continue to cover 90 percent of the added populations’ health costs in a budget-cutting era.

Kansas continues to negotiate with federal Medicaid officials.

Brownback still hasn’t said no.

To reach Steve Kraske, call 816-234-4312 or email skraske@kcstar.com. Follow him @stevekraske.

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